患者相关因素对单节段经椎间孔开放性腰椎椎间融合术中隐性失血量和总失血量的影响。

IF 1.1 4区 医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2022-07-01 DOI:10.5152/j.aott.2022.21380
Gökhan Kürşat Kara, Hüseyin Kavak, Bahadır Gökçen, Kaya Turan, Çağatay Öztürk, Ufuk Aydınlı
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引用次数: 1

摘要

目的:本回顾性研究的目的是通过多元线性回归分析确定单节段OTLIF手术中TBL和HBL的数量,并分析其危险因素。方法:本研究纳入了2015年至2021年间由同一位外科医生行单节段椎体间融合术的62例患者(男性32例,女性30例,平均年龄49.22±13.26岁)。回顾性收集体重指数(BMI)、美国麻醉医师学会评分(ASA)、术前平均动脉压(MAP)、年龄等相关数据。术前mri图像用于评估和测量皮肤-椎间盘距离(SDA)、椎管面积(CA)、椎旁肌面积(PVMA)、腰骶最大皮下脂肪厚度(LSMSF)、手术水平皮下脂肪厚度(OPSF)和棘突长度(SPL)等影像学参数。总失血量(TBL)按Nadler公式计算。隐性失血量(HBL)通过从TBL中扣除测量到的(可见)失血量来测量。评估TBL、HBL及其与术前参数的关系。结果:老年患者HBL明显增高(P = 0.012)。MAP与手术时间(P = 0.002)、术中出血(P = 0.002)、TBL (P = 0.006)、HBL (P = 0.001)呈正相关,与术后引流呈负相关(P = 0.007)。ASA评分与TBL (P = 0.001)、HBL (P = 0.001)有统计学意义相关。LSMSF与TBL (P = 0.005)、HBL (P = 0.002)有显著相关性。OPSF与TBL (P = 0.011)、HBL (P = 0.009)、住院时间(P =0.034)相关。SDD与TBL相关(P =0.043), SPL与HBL相关(P = 0.013)。结果显示,年龄(P =0.012)、MAP (P =0.001)、ASA (P =0.001)、LSMFS (P = 0.002)、OPSF (P = 0.009)、SPL (P = 0.013)是HBL的危险因素。根据多元logistic回归分析;LSMSF和SPL是HBL的独立危险因素(P < 0.05)。结论:本研究结果显示,大多数患者相关参数对HBL和TBL有显著影响。研究还表明LSMSF和SPL是HBL的独立危险因素。证据等级:IV级,治疗性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The effects of patient related factors on hidden and total blood loss in single-level open transforaminal lumbar interbody fusion surgery.

Objective: The aim of this retrospective study was to identify the amount of TBL and HBL and analyse the risk factors using multivariate linear regression analysis during single-level OTLIF surgery.

Methods: In this study 62 patients (32 male, 30 female, mean age 49.22 ± 13.26) who underwent single-level interbody fusion proce dures by a single surgeon between 2015 and 2021 were included. Retrospectively, relevant statistics regarding body mass index (BMI), American Society of Anesthesiologist Score (ASA), preoperative mean arterial pressure (MAP), and age were gathered. Preoperative MR images were used to assess and measure radiological parameters such as skin-disc distance (SDA), canal area (CA), paravertebral muscle area (PVMA),lumbosacral maximum subcutaneous fat thickness (LSMSF), operation level subcutaneous fat thickness (OPSF) and spi nous process length (SPL).Total blood loss (TBL) was calculated according to Nadler's formula. Hidden blood loss (HBL) was measured by deducting the measured (visible) blood loss from TBL. TBL, HBL and their relationship with preoperative parameters were assessed.

Results: HBL was determined to be significantly higher in older patients (P = 0.012). MAP was seen to have a statistically significant cor relation with operating time (P = 0.002), operative bleeding (P = 0.002), TBL (P = 0.006), and HBL (P = 0.001), and an inverse correlation with postoperative drainage (P = 0.007). The ASA scores were observed to be statistically significantly correlated with TBL (P = 0.001), and HBL (P = 0.001). LSMSF showed a significant correlation with TBL (P = 0.005) and HBL (P = 0.002). OPSF was determined to be correlated with TBL (P = 0.011), HBL (P = 0.009) and length of stay in hospital (P =0.034). SDD was correlated with TBL (P =0.043), and SPL with HBL (P = 0.013). It was shown that age (P =0.012), MAP (P =0.001), ASA (P =0.001), LSMFS (P = 0.002), OPSF (P = 0.009), SPL (P = 0.013) were risk factors for HBL. According to multivariate logistic regression analysis; two anatomical factors LSMSF and SPL were independent risk factors for HBL (P < 0.05).

Conclusion: This results of this study have revealed that most patient-related parameters have a significant effect on HBL and TBL.The study has also demonstrated that LSMSF and SPL are independent risk factors for HBL.

Level of evidence: Level IV, Therapeutic Study.

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来源期刊
CiteScore
2.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.
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